| Care For Vulnerable Population Fails To Improve
For the third year in a row, NCQA found that the
performance of health plans serving Medicare and Medicaid patients
failed to appreciably improve quality on key measures.
That was called "unacceptable" by Vernon K. Smith, a
principal in Lansing, Mich.-based Health Management Associates, and one
of the nation’s leading experts on Medicaid. "Three years of
little or no improvement in care quality is truly surprising, and
should be unacceptable."
More than 100 million Americans depend on Medicare and
Medicaid for their care and that number is growing. Enrollment grew in
2008 and will grow even more as the economy remains in free fall and
the Baby Boom generation becomes eligible.
Congress is considering making changes to
Medicare’s payment system for these plans, including the
introduction of financial incentives to improve quality.
In another disturbing trend, the study found that
quality of care varies from region to region in America. For example,
Health plans in the New England region treating diabetes and
cardiovascular disease continued to outpace all others and the quality
of care in the South Central region for diabetes and cardiovascular
disease did the worst.
"These quality gaps translate into preventable heart
attacks, strokes and other serious medical events, not to mention
billions of dollars in avoidable medical costs," said Cristie Upshaw
Travis, CEO of the Memphis Business Group on Health.
NCQA again measured the value of health plans by
combining quality measures with an assessment of how many resources
were used to achieve those results. There were wide variations in both
spending and quality and NCQA found essentially no relationship between
cost and quality.
"Healthcare doesn’t follow the pay-more get-more
rule," said NCQA Executive Vice President Dr. Greg Pawlson. "You
can’t simply spend your way to better health or to a health care
system that delivers high value for the costs."
NCQA’s full State of Health Care Quality 2009 report is available on the Web at www.ncqa.org/sohc. To see the Health Plan Report Card, visit http://reportcard.ncqa.org.
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